John T Peterson, C.R.N.A.

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

41232 Issued in WV

Practice address

150 Memorial Dr
Kingwood, WV 26537-1141

Phone

(304) 329-1400

Fax

(304) 329-1175

NPI assigned

Jul 11, 2006

Last updated

Apr 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greenbrier VMC LLC

  dba Greenbrier Valley Medical Center

  • Internal Medicine Physician
  • Ronceverte, WV
  • NPI 1275546996
  NPD (past)
• Greenbrier VMC LLC

  • Surgery Physician
  • Lewisburg, WV
  • NPI 1417153172
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1487689139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MEMORIAL DR",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371141",
            "telephone_number": "304-329-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MEMORIAL DR",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371141",
            "telephone_number": "304-329-1400",
            "fax_number": "304-329-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "WV",
            "license": "41232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Darlene Parks
• Kevin A Passerby, MPT
• Suzanne Peddicord, RN, BSN
• Nicole Lorraine Peery
• Rachael Pellegrino
• Tammy Jo Phares
• Dennis Pifer
• Jillian Rae Pino
• Preston County Board of Education
• Preston County Board of Education

• Medical-Surgical Registered Nurse in Kingwood, WV
• Providers in Kingwood, WV by specialty
• Medical-Surgical Registered Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.